This Sunday, Sept. 10, is World Suicide Prevention Day, which gives us all an opportunity to think about the ways we can help prevent suicide and show support for the loved ones in our lives.

This is an especially important topic for adolescents, an age group where suicide is a significant cause of death. The statistics are sobering:

Suicide is the second-leading cause of death among teenagers ages 15-19.

Suicide is at an all-time high among middle schoolers ages 10-14 and has surpassed car crashes as the leading cause of death.

Overall, teen suicide has tripled in the last 50 years, killing more teens than all diseases combined.

Why is suicide risk so high among adolescents?

Research shows that there are many factors beyond genetic predisposition and mental illness that influence suicide risk during adolescence.

The adolescent phase is associated with physical, emotional and social changes. Lack of family support, unrealistic expectations, academic pressure, social isolation and victimization can lead to disappointment, depression or simple overreaction that may result in a self-inflicted injury or death.

Other risk factors for teens include:

Having access to a firearm.

Being a victim of dating violence and/or sexual assault.

Being bullied, either at school or cyberbullying.

Using or abusing drugs or alcohol.

Having a conflict with a parent.

Lacking a support system or someone to talk to.

Recognize the warning signs

Be aware of the following warning signs and behaviors that could indicate a teen is at risk for suicide:

Talking about wanting to die or about feeling trapped.

Acting anxious or agitated.

Behaving recklessly.

Experiencing changes in mood, diet or sleeping patterns.

Becoming socially isolated.

Declining school performance.

Giving away belongings.

Creating poems, essays or drawings that refer to death.

Dramatically changing their appearance.

Expressing a sense of guilt, shame or rejection.

Talking about feeling unbearable pain, or feeling like a burden to others

Understand the common myths about suicide

Myth 1: Asking someone about suicide will cause him to become suicidal. Asking about suicide can actually help prevent it.

Myth 2: Depression causes all suicides. Less than half of teens who commit suicide have a proven diagnosis of depression and only a fraction of depressed teens commit suicide.

Myth 3: Suicides always happen in an impulsive moment. Many teens will plan a suicide for a long time, often seeking help or trying to attract attention before acting.

Myth 4: Young children cannot be suicidal. They can be, and there is evidence of kids as young as 5 committing suicide

Myth 5: We cannot really prevent suicides. If we all work together, we can reduce suicide significantly. Our grassroots program, Stop Youth Suicide Campaign, has helped more than 20,000 teens over the last 18 years.

How you can help

We all, regardless of our education level or profession, can help prevent and reduce teen suicide. Here’s how:

Talk to your teens on regular basis. Ask them about their feelings, their conflicts, possible bullying and anything else going on in their lives.

Make sure there are no means of suicide available at home, especially firearms. Having a firearm at home, even with no other risk factors, increases suicide risk fivefold.

Show love and support, not punishment or ignorance, when your teen shares something with you.

Assure your teen that you are always there for them and listen to their issues.

Next steps:

The team at UK Adolescent Medicine has expertise in a wide range of adolescent concerns. We work to address each patient’s unique emotional, physical and psychological needs. Learn more.

http://ukhealthcare.net/wp-content/uploads/2017/09/teen-suicide.jpg5001200UK HealthCarehttp://ukhealthcare.net/wp-content/uploads/2016/05/UKHCLogo288x73.jpgUK HealthCare2017-09-07 18:05:242017-09-11 12:48:06Teen suicide is preventable: Here’s how you can help

University of Kentucky researchers have observed a significant reduction in sexual violence perpetration and victimization among Kentucky high school students, according to a recently published study on the “Green Dot” bystander intervention program.

Led by Ann Coker and Heather Bush of the UK Center for Research on Violence Against Women (CRVAW), the study is the largest and longest randomized controlled trial of bystander intervention programs focusing on sexual violence prevention in high schools. Published this week in the American Journal of Preventive Medicine, the study reveals the implementation of Green Dot in Kentucky high schools decreased not only sexual violence perpetration, but related forms of violence including sexual harassment, stalking and dating violence.

Green Dot, designed by former UK faculty member Dorothy Edwards, has been in use at the university since 2008. It teaches students how to identify situations that could lead to an act of violence (represented on incident maps by a red dot) and shows them how to intervene safely and effectively. A “green dot” represents “any behavior‚ choice‚ word or attitude that promotes safety for all our citizens and communicates utter intolerance for violence.”

“This research is great news for parents, schools, young adults and adolescents across Kentucky and the USA,” said Coker, who is the Verizon Wireless Endowed Chair in CRVAW and professor in the UK College of Medicine. “We found that sexual violence can be prevented – this violence is not inevitable. Adolescents and young adults can learn how to identify risky situations and safely intervene to prevent violence.”

Targeting a serious issue in Kentucky

Sexual violence continues to be a serious problem for Kentucky teens. One in seven high school students in Kentucky experience physical dating violence, and one in 11 have had unwanted sex because they were physically forced or too intoxicated to give consent. Bystander training programs such as Green Dot teach individuals how to recognize situations or behaviors that may become violent and intervene to reduce the likelihood of violence.

Funded by the Centers for Disease Control and Prevention, the study followed 26 Kentucky high schools over the past five years. Half of the schools were assigned to receive the Green Dot intervention, with the others serving as the study’s control group. Interventions were conducted by trained rape crisis educators. The Kentucky Association of Sexual Assault Programs served as a community partner in the trial and covered the cost of Green Dot training for at least one staff person at each regional center across Kentucky. By using these existing resources, the schools encountered no additional costs to implement the program.

The interventions were implemented in two phases. In Phase 1, rape crisis educators delivered Green Dot speeches to all students in the intervention schools. In Phase 2, educators implemented intensive bystander training. This training was conducted in smaller groups by high school students perceived as leaders by their peers (12-15 percent of the student body).

Changing the culture takes time

Each spring from 2010 to 2014, students at each school completed anonymous surveys to measure the frequency of violence they personally experienced, termed “victimization,” as well as the frequency of violence they personally inflicted, termed “perpetration.” All students, in both intervention and control schools, received hotline numbers and website information. Rape crisis staff were also available at each school to talk with any students who needed assistance.

A total of 89,707 surveys were completed over the five-year period, and researchers compared survey-reported data before program implementation with rates from 2010-14. Regarding sexual violence victimization, rates were 12 to 13 percent lower in the intervention versus control schools in years three and four, respectively. This translates to 120 fewer sexually violent events in year three, and 88 fewer in year four, indicating that sufficient time is required to see the ultimate effect of the training on violent behaviors.

“In this study we sought to change the culture that supports violence in high schools, and making these changes requires time,” Coker said. “Fortunately, we had five years to implement and evaluate these changes and we definitely needed all five years. We saw reductions in violence acceptance and increases in bystander actions in the second and third years of the study, but we did not see significant and consistent reductions in sexual violence and other forms of violence until the fourth and fifth years of the study when Green Dot training was fully implemented.”

UK President Eli Capilouto praised the study and the Green Dot program for making both college campuses and high schools safer.

“As educators, we have an obligation to provide our students with a safe place to live and learn,” Capilouto said. “The Green Dot program was ahead of the curve when it was established at the University of Kentucky. Today, it is an effective bystander intervention training tool on college campuses across the country, and the results of the Center for Research on Violence Against Women’s study illustrates its effectiveness in high schools. Providing this important training earlier supports all our efforts to make high schools and college campuses safer for all people.”

Next steps:

For more insights and information related to the unique health concerns of teens and young adults, check out our adolescent medicine blog series written by by Dr. Hatim Omar and his team in UK Adolescent Medicine.

Written by Jennifer Perry, LCSW, a social worker at UK Adolescent Medicine. This post is part of a series written by Dr. Hatim Omar and his team in Adolescent Medicine related to the unique health concerns faced by teens and young adults.

Last Thursday, more than 100 Lexington high schoolers gathered to promote positivity among their peers and send messages of encouragement, or lifelines, to one another. Around Valentine’s Day every year for the past eight years, UK Adolescent Medicine and Stop Youth Suicide have hosted the event, called Spread the Love-A-Thon, to raise awareness about teen suicide and mental health.

The event is centered on the idea of making lifelines. Participants make lifelines with their peers by sharing compliments via social media, text message, phone call or any other means of technology. They also share statistics about suicide. The idea is to put daily social media habits and interaction to good use.

Teens spend hundreds of hours with their friends, but how often do they talk about why they like each other? Spread the Love-A-Thon is an opportunity for our participants to tell their friends something specific they appreciate and why it makes them special. The hope is that the compliment will stick, and the person will remember it when they have a bad day.

During the event, teens don’t have to read from a printed script but are urged to offer one or two genuine compliments. The best compliments usually start with something that the teen appreciates about the other person. It’s best when that thing isn’t something that changes often or easily.

We also encourage the students to share statistics that show just how common thoughts of suicide are in the adolescent population. For example, one in three Kentucky high school students report being sad or depressed to the point that their daily functioning is impaired. Even I was pretty shocked to learn that 11 percent of high schoolers in the U.S. have made a plan to commit suicide, and 9 percent actually attempt suicide every year.

Each participant tracks their lifelines over the course of the two-hour event. At the end, we celebrate with pizza and recognize the 50 participants who created the most lifelines. In 2016, we had 165 participants who made 6,905 lifelines!

For the past three years the event has been held at Tates Creek High School in Lexington and has been co-hosted by the Tates Creek’s FCCLA club (Family, Career and Community Leaders of America). Having it at Tates Creek gives students the opportunity to really own the event. They make unique invitations to Spread the Love and hand deliver them the day before the event. They also do a week of suicide awareness in their school by hanging posters with statistics and hosting a wellness fair, where they invite community members to share information about resources available to teens.

Ultimately, Spread the Love-A-Thon is an opportunity for students to see how meaningful simple gestures of kindness and positivity can be.

“This event is so important because so many people really doubt themselves. Some people don’t really think they’re worth anything, so events like this are great for people to come spread positive vibes, give love,” said Blake Caudill, a senior at Tates Creek High School. “You never know what a text message could do – how it could help someone’s day.”

Next steps:

UK Adolescent Medicine works closely with UK Adolescent Behavioral Health, an inpatient program that offers a personal, structured environment for adolescents with mental illness or behavioral health problems.

Uniting with each of the 69 National Cancer Institute-designated cancer centers, the UK Markey Cancer Center is once again urging young people in the U.S. to get a vaccination against the human papillomavirus, or HPV.

HPV vaccination rates are low, especially in Kentucky

According to the Centers for Disease Control and Prevention, or CDC, incidence rates of HPV-associated cancers continue to rise, with approximately 39,000 new HPV-associated cancers now diagnosed each year in the U.S. Although HPV vaccination can prevent the majority of cervical, anal, oropharyngeal (middle throat) and other genital cancers, vaccination rates remain low across the U.S., with just 41.9 percent of girls and 28.1 percent of boys completing the recommended vaccine series.

In Kentucky, the rates are even lower, with just 36.2 percent of adolescent girls and 17.1 percent of adolescent boys having completed the series.

New guidelines from the CDC recommend that children aged 11 to 12 should receive two doses of the HPV vaccine at least six months apart. Adolescents and young adults older than age 15 should continue to complete the three-dose series.

“HPV vaccination rates in Kentucky are extremely low, especially among adolescent males,” said Dr. Mark Evers, director of Markey. “We fully support these new immunization guidelines and hope they encourage more parents to have their children vaccinated, which will significantly lower their risk of developing these largely preventable cancers.”

Improving HPV vaccination can save ‘thousands of lives’

Research shows there are a number of barriers to overcome to improve HPV vaccination rates, including a lack of strong recommendations from physicians and parents not understanding that this vaccine protects against several types of cancer.

In an effort to overcome these barriers, NCI-designated cancer centers have organized a continuing series of national summits to share new research, discuss best practices and identify collective action toward improving HPV vaccination rates. The original joint statement, published in January 2016, was the major recommendation from a summit hosted at The University of Texas MD Anderson Cancer in November 2015, which brought together experts from the NCI, CDC, American Cancer Society and more than half of the NCI-designated cancer centers, including Markey.

“We have been inspired by the White House Cancer Moonshot to work together in eliminating cancer,” said Electra Paskett, PhD, associate director of The Ohio State University Comprehensive Cancer Center – Arthur G. James Cancer Hospital and Richard J. Solove Research Institute (OSUCCC – James) Cancer Control Research Program. “Improving HPV vaccination is an example of an evidence-based prevention strategy we can implement today to save thousands of lives in the future.”

The updated statement is the result of discussions from the most recent summit, hosted this summer by OSUCCC. Nearly 150 experts from across the country, including representatives from the Markey, gathered in Columbus to present research updates and plan future collaborative actions across NCI-designated cancer centers.

At the beginning of the year, many women (and men) set resolutions around health and fitness, often focusing on weight loss. But one of the most important habits women can form revolves around regular health checks, particularly for preventable cancers.

January is Cervical Cancer Awareness Month. Unfortunately, Kentucky ranks in the top 10 in the country for cervical cancer incidence and death rates – a dire statistic considering cervical cancer is largely preventable through vaccination and screening.

Risk-factors for cervical cancer

The human papillomavirus (HPV) causes virtually all cases of cervical cancers. The majority of sexually active women will be exposed to HPV at some point in their lifetime; fortunately, only 5 to 15 percent will develop cervical precancer. An even smaller percentage will develop cancer. Other risk factors include multiple pregnancies, a long duration of birth control pill use, a history of other sexually transmitted diseases and tobacco use.

The importance of the HPV vaccine

Nowadays, you can take an extra step toward protecting your children against cervical and other types of HPV-related cancers through the HPV vaccine. This vaccination used to be a three-dose process, the CDC now recommends that all 11 to 12 year-old children – girls and boys – get just two doses, with the second being given six to 12 months after the first.

Young women can get the vaccine through age 26, while young men can get vaccinated through age 21. Every year, more than 17,000 women and more than 9,000 men get cancer caused by an HPV infection.

Don’t overlook getting a Pap smear

Cervical cancer screening – the Pap smear – is a regular appointment that is often overlooked. This test looks for cancerous cells on the cervix and can even find precancerous changes that have not yet developed into cancer.

I can’t recommend this test enough – at Markey, about 95 percent of cervical cancer patients we treat have not gotten their recommended schedule of cervical cancer screenings. Screenings usually begin at age 21 or three years after first sexual intercourse. Talk to your doctor about a timeline for regular screenings.

Cervical cancer symptoms

One reason the vaccine and screenings are so important is because cervical cancer often doesn’t cause obvious symptoms until its more advanced stages. Some of the most common symptoms reported include abnormal bleeding or bleeding after sexual intercourse, and an abnormal discharge. Many of these symptoms can be mistaken for less serious issues, such as a yeast infection or urinary tract infection.

As the cancer advances further, it can cause urinary blockage, back pain, leg swelling or neuropathic pain, such as a “pins and needles” sensation in the skin.

As you work through your resolutions for the New Year, make taking care of yourself a priority – and that includes scheduling a few regular trips to your doctor.

Next steps:

If you or someone you love is interested in receiving the HPV vaccine, schedule an appointment with the Markey Cancer Center online or at 859-323-5553.

Long-acting reversible contraceptives are the most effective form of reversible birth control but not the most commonly used. Misconceptions and outdated misinformation prevent many people from realizing the benefits of intrauterine devices (IUDs), contraceptive implants and the birth control shot. While use of these contraceptives has increased over time, they are still much underutilized.

Types of LARCs

IUDs are small devices that are placed inside the uterus. There are several varieties of IUDs, some containing hormones and some without. These various devices can prevent pregnancy for different amounts of time, typically between three and 12 years. The contraceptive implant is a small rod placed under the skin in the upper arm and can prevent pregnancy for up to three years. The Depo Provera contraceptive shot is effective for three months before another shot needs to be administered.

Debunking the misconceptions

One common misconception about LARCs is that they are unsafe. However, not only are LARCs effective, they are also very safe. There are few women for whom using LARCs would not be an option. Additionally, LARCs are safe for use in adolescents, young women and women who have not had children. Of course, it’s important to speak with your healthcare provider about personal and sexual health history and to ask about symptoms that could be cause for concern.

Another misconception surrounding LARCs is that they have a detrimental effect on future fertility. Research has shown about 71 percent of women who wanted to become pregnant conceived within 12 months of removing IUDs. (This is comparable to the general population). It is important to talk to your provider about personal goals regarding future pregnancy; this will impact the type of contraception that is best for you.

The most effective form of reversible contraception

Finally, LARCs are the most effective form of reversible contraception on the market; less than one percent of users will become pregnant. Pregnancy occurs in up to 18 percent of women who use condoms as their primary method of birth control and in about 9 percent of women using oral contraception. This often occurs because of inconsistent or incorrect use. Because LARCs don’t require women to remember anything on a daily, weekly or monthly basis and require a visit to a health care provider for removal, they prevent user error, which often occurs with other forms of contraception.

About 50 percent of all pregnancies in the United States are unintended. It is important that we provide information and access to the safest and most effective forms of birth control. LARCs can provide safety and security for most women, and should be considered along with other forms of contraception.

Written by Jennifer Coffaro, PA-C, advanced practice provider at UK Adolescent Medicine and the Young Parents Program. This post is part of a series written by Dr. Hatim Omar and his team in Adolescent Medicine related to the unique health concerns faced by teens and young adults.

Teen pregnancy rates have dropped to historic lows in the United States, but compared to other developed countries, our rates remain high. Regardless of why this is, teen pregnancy continues to be a public health concern.

Young people born to teen parents are more likely to become teen parents themselves, and current teen mothers are at greater risk for repeat teen births. Young women in foster care are twice as likely to be a pregnant teen.

In Kentucky, nearly half of all high school students are sexually active. However, only about 40 percent of these students use hormonal birth control and only 40 percent use condoms.

Starting a conversation

Sexuality and sexual desire are normal parts of human development. Teens need to be provided with an environment where they are comfortable discussing their sexuality. Ideally, these conversations should happen before teens become sexually active.

It is important for parents and guardians to be willing to discuss abstinence and safe sexual practices with teens. Too often, teenagers look to their peers or the internet for advice, which can be inaccurate. Medical providers are also great resources for teens and parents who may be uncomfortable discussing sex.

How we can help

UK Adolescent Medicine provides contraceptive education and care for teenagers and their families. Our counselors are experts at communicating with adolescents and will work with you and your family to address any concerns you might have related to pregnancy or contraception.

We offer additional resources and information about numerous contraceptive methods that are safe and effective in reducing the risk of pregnancy.

We respect the privacy of teens and their families. You can be sure that all discussions and care are absolutely confidential.

Next steps:

The Young Parents Program at UK was created to address the unique health concerns of young parents and their children. Learn more about our program.

Read Omar’s post about how UK Adolescent Medicine is helping improve health and well-being for teens and young adults across Kentucky.

Although they can be concerning for both teens and parents, headaches during adolescence are a common part of growing up.

In fact, about 90 percent of adolescents experience a headache by the time they turn 18. Headaches may be sharp or dull; they may be associated with nausea or light sensitivity; and they may be located in the front, back or sides of the head.

Prevention and treatment

For teenagers and young adults, headaches have a wide array of triggers, many of which can be identified and corrected with simple lifestyle changes. Here are some tips to help you prevent headaches:

Drink at least eight glasses of water per day, more if you’re active.

Get a minimum of eight hours of sleep daily.

Exercise at least three days a week.

Limit screen time – including television, smartphone and computer – to two hours a day.

Eat a well-balanced diet that includes five to nine servings of fresh fruits and vegetables daily.

Limit the use of over-the-counter medications to two days per week and avoid aspirin.

If you do experience headaches, try these tips for treatment:

Identify factors that trigger headaches. Common triggers include bright lights, certain odors, smoke, oversleeping or lack of sleep, food, or temperature changes in the home or environment.

Keep a headache diary to help track the characteristics and patterns of your headaches. This can help you figure out what’s causing them.

If you are prescribed a medication, take it as directed.

Apply a cold compress to your head.

Sit in a cool, quiet and stress-free environment.

A sign of something more serious

Although most headaches are nothing to be worried about, some can be a sign of more serious health concerns. Talk to your parents about making a doctor’s appointment if you have:

Headaches that force you to miss school, cause a decline in academic performance or limit your participation in extracurricular activities.

Headaches that cause you to wake up from sleep or are more severe when you are lying down.

Headaches after a recent trauma or fall.

Neurological symptoms such as weakness, confusion or seizure activity that occur with headaches.

Persistent nausea and vomiting.

Sudden and severe onset of headaches.

Progressive headaches, or headaches that get worse over time.

Headaches that do not respond to treatment.

Headaches and a medical history that increases risk of severe health concerns, including sickle cell disease, immune deficiency, history of malignancy, bleeding disorders, cardiac disease or recent head trauma.

Adolescence is a time of physical, psychological and cognitive changes. It is an important phase for teens to discover who they really are, how they are perceived and how they fit into the environment they in which they live.

Sexual and gender identity development are two of the most important tasks young adults face during adolescence. For those who identify as gay, lesbian, bisexual, transgender or queer (LGBTQ), these tasks can be a tremendous challenge.

LGBTQ teens face unique challenges

LGBTQ teens often cope with feelings of being different and face dilemmas about revealing their identity, which can be at odds with family and social expectations.

They may encounter family rejection, face harassment, prejudice, discrimination and social isolation in schools as well as communities. According to a national survey, many of these teens face verbal and electronic aggression in school. These experiences at school and the potential lack of family and community support affect the overall psychological and physical well-being of LGBTQ youth.

In fact, LGBTQ teens are eight times more likely to attempt suicide than their peers. They are also three times more likely to engage in substance abuse, unprotected sexual intercourse and have multiple sexual partners leading to increased risk for sexually transmitted infections.

How we can help

Research has shown that family acceptance and support promotes overall well-being and helps protect LGBTQ youth against risk taking behaviors. Our Adolescent Medicine Clinic at UK is committed to providing specialized and comprehensive care for LGBTQ youth in an inclusive and safe environment.

We also work with families to help them understand sexual and gender identity development and provide individual and family therapy.

Looking toward the future, our clinic is currently in the process of developing a multidisciplinary approach for providing a comprehensive health and hormonal therapy for transgender youth in the state of Kentucky.

To make an appointment with UK Adolescent Medicine, visit our website or call 800-333-8874.

Next steps:

Learn more about Transform Health, a University of Kentucky initiative working to improve LGBTQ patient care and provide safe clinical environments for LGBTQ individuals seeking care.

Written by Dr. Hatim Omar, chief of the Division of Adolescent Medicine at UK HealthCare. This blog is the first in a series of posts by Dr. Omar and his team related to the unique health concerns faced by teens and young adults.

When I came to Lexington in 1998, I faced a tough assignment.

Tasked with starting UK HealthCare’s Adolescent Medicine program, I knew that teens in Kentucky were worse off than almost anywhere else in the country. High rates of obesity, suicide, pregnancy and drug use all plagued the Commonwealth’s adolescent population. Instead of seeing the statistics as an insurmountable challenge, I saw an opportunity.

My outlook from the start was that we could make a difference. I knew it wouldn’t take much to change Kentucky if we did things the right way.

That meant tackling adolescent health through three approaches – direct patient care, governmental advocacy and community outreach. I’m happy to say that we have been successful.

Our Adolescent Medicine Clinic now sees more than 10,000 patients each year, and in the nearly 17 years since the program started at UK HealthCare, adolescent health outcomes in Kentucky have improved across the board.

But as with most things, there’s always room for improvement. And that’s why I’m starting this blog about adolescent health and well-being.

One of the most important things we can do – as health care providers, parents, teachers, caregivers and peers – to successfully improve the health of teens and young adults is to facilitate honest and open conversations.

In the coming months, my team in Adolescent Medicine and I will author blog posts about the most pressing health concerns we see in our clinic every day. My hope is that this blog can enhance those conversations and bring the discussions about the unique health concerns faced by adolescents to a wider audience.

I encourage you to share this post with the young adults in your life as well as parents and caregivers who have teenagers.